소아의 소장 중첩증의 치료 : 자연 정복 vs 수술적 치료

김은영,정규환,박태진,박귀원,정성은,김현영,Kim, Eun-Young,Jung, Kyu-Whan,Park, Tae-Jin,Park, Kwi-Won,Jung, Sung-Eun,Kim, Hyun-Young 대한소아외과학회 2010 소아외과 Vol.16 No.2

Unreduced small bowel intussusception requires operative treatment although the rate of spontaneous reduction is 60 to 70 %. The aim of this study is to compare clinical characteristics and outcome between spontaneous reduction and operation group and to analyze factors related to decisions to treat small bowel intussusceptions. The records of 25 patients with small bowel intussusceptions treated in Seoul National University Children's Hospital from January 1999 to August 2009 were reviewed respectively. Spontaneous reduction group (n=12, 48 %) had signs and symptoms of vomiting, abdominal pain, currant jelly stool, abdominal distension, fever, increased CRP but no rebound tenderness. One of them had been diagnosed with Henoch-Schonlein purpura and no one displayed pathologic leading point by image study. Operation group (n=13, 52 %) consisted of patients who had primary surgery. Their signs and symptoms were similar to spontaneous reduction group. Seven of them had underlying diseases such as Crohn' disease, ALL, Lymphoma, Peutz-Jeghers syndrome (n=3), post-transplanted state of liver and 2 of them displayed Peutz-Jeghers polyp and Meckel's diverticulum as pathologic leading point by preoperative ultrasonography. Mean relieve interval (interval between onset of symptoms and reduction/operation) was 1.78 days in spontaneous reduction group and 2.25 days in operation group (p=0.341). Seven of operation group had manual reduction and 6 out of 7 received segmental resection of the small bowel. No one of them underwent manual reduction and all of them underwent segmental resection were found to have pathologic leading points [Peutz-Jeghers polyp (n=3), Meckel's diverticulum (n=2), lymphoma (n=1)] during operation. In conclusion, 48% of small bowel intussusceptions resolved spontaneously. Patients' symptoms and relieve intervals were not related to the operative decisions. We therefore recommend significant factors for determining treatment plan such as change of clinical symptoms, underlying disease or pathologic leading point by imaging.

반복 발화의 음성 축약 현상에 미치는 영어 능숙도의 효과

오세진 ( Se Jin Oh ),이용은 ( Yong Eun Lee ) 대한언어학회 2015 언어학 Vol.23 No.3

Both L1 and L2 learners are known to show phonetic repeated mention reduction (e.g. Bell et al., 2009). Relatively few studies, however, exist on how L2 learners`` proficiency influences the reduction. The present study thus examined effects of language proficiency on repeated mention reduction in L2 conversational English speech. A significant effect of L2 proficiency on duration was found. Specifically, as with native English speakers, Korean learners with high English proficiency phonetically reduced the duration of repeated words, while those with low English proficiency did not. We suggest that the current findings support a production model (e.g., Gahl, Yao & Johnson, 2012) where the level of one`` L2 proficiency is reflective of how L2 learners modulate the link between the lexical access and the articulatory planning.

즉각적 영어발화에 나타난 한국인 영어학습자의 영어 음절말 자음군 축약 양상에 관한 연구

이용은,오세진 한국중앙영어영문학회 2013 영어영문학연구 Vol.55 No.2

It is well known that native speakers of English systematically reduce consonant clusters appearing in word-final position (e.g., next class → [nɛks klæs], Yavaş, 2006). A number of previous studies based on Korean speakers’ English word reading task have reported that to some extent Korean learners of English are aware of the linguistic variables that affect native speakers’ reduction patterns of word-final consonant clusters (e.g., Lee & Cho, 2005). The goal of the current study is to examine to what extent the previously reported patterns of consonant cluster reduction by Korean learners of English in their reading task are found when they interact with a native speaker of English in a spontaneous communicative setting. Using a spot-the-difference method (Kim et al., 2011), the present study shows that Korean speakers’ patterns of English consonant cluster reduction revealed in their reading task are not always consistent with the patterns gathered in their spontaneous English speech. In particular, unlike the results from previous studies, longer consonant clusters (i.e., clusters made up of three consonants) did not show a higher rate of reduction than shorter consonant clusters (i.e., clusters made up of two consonants). Discussions are provided regarding the factors that are potentially responsible for this discrepancy. More generally, discussions are provided regarding the effect of spontaneous speech on the word-final consonant cluster reduction by Korean learners of English.

소아 장중첩중의 임상적 고찰 : 개복시 자연 정복예의 특성

박진우 충북대학교 의과대학 충북대학교 의학연구소 1999 忠北醫大學術誌 Vol.9 No.2

연구 목적: 소아 장중첩증은 2세 이하의 남아에서 호발하는 장폐색의 흔한 원인의 하나로, 대부분의 경우에서 비수술적 정복으로 치료될 수 있다. 비수술적 정복이 실패하면 수술적 치료를 요하게 되는데 일부에서 개복시 이미 중첩된 장이 풀려있는 경우가 발견된다. 본 연구는 이러한 개복시 자연 정복을 보이는 예의 임상 특성을 알아보고, 외과적 관찰을 적응이 될 수 있는 환자군을 선별해 보는데 그 목적이 있다. 대상 및 방법: 1994년 6월부터 1997년 12월까지 충북대학교병원에서 장중첩증 환아에서 시행한 비수술적 정복은 170예로, 이들 중 바륨 정복이 시행된 경우가 117예, 공기압 정복이 시행된 경우가 51예, 초음파 유도하의 식염수 관장이 시도된 경우가 2예 있었다. 비수술적 정복의 실패로 개복이 필요했던 경우는 50예였는데, 이들 수술예 중 개복시 자연 정복이 관찰된 경우는 7예였다. 이들 자연 정복예를 대상으로 임상 소견과 비수술적 정복의 결과, 수술 소견 등을 임상 고찰하였다. 결과: 1. 개복시 자연 정복이 관찰된 경우는 7예로 전체 개복예의 14%를 차지하였다. 2. 남아가 4예, 여아가 3예였고, 1세 미만이 4예였다. 3. 임상 증상은 발열(BT>38℃)이 2예, 복통이 3예, 보챔이 4예, 구토가 4예, 점액성 혈변이 6예, 복부 종괴가 1예에서 있었다. 선행된 상기도 감염의 병력은 2예에서 있었고, 백혈구 증가(WBC>10,000 /mm3)의 소견은 4예에서 있었다. 4. 증상 기간은 3 시간에서부터 72시간까지로 평균 37.4시간이었다. 5. 비수술적 정복의 결과 중첩된 장의 정복이 회맹부 근처에까지 진행되었으나 회장 말단부로의 역류가 관찰되지 않았다. 6. 자연 정복이 관찰된 예에서는 모두 비수술적 정복 후 동통이나 보챔이 소실되었다. 결론: 소아 장중첩증의 비수술적 정복 후 중첩된 장이 회맹부 근처까지 정복되고, 환자의 증상이 소실되면, 회장 말단부로의 역류가 관찰되지 않더라도 일정기간 외과적 관찰을 시행하고 다시 비수술적 정복을 시도하는 방법을 고려해 볼 수 있겠다. Purpose: Intussusception is one of the most common causes of intestinal obstruction in children under the age of 2 years, especially in male. Operations are required if non-surgical managements fail. At operation, spontaneous reduction of intususceptum is not infrequently observed. In this study, Characteristics of spontaneous reductions at operation were analyzed and subgroup was suggested who could be observed surgically. Materials and Methods: From Jun. 1992 to Dec. 1997, 170 pressure reductions were performed in childhood intussusceptions at Chungbuk national university hospital. Operation was required in 50 patients. Spontaneous reduction was observed in 7 patients. Clinical presentations, results of non-surgical managements and operative findings of these 7 patients were reviewed. Results: 1. Spontaneous reduction was observed in 7 patients (14% of operative cases). 2. There were 4 boys and 3 girls. Four of them were under the age of 1 year. 3. Clinical presentations were fever, abdominal pain, irritability, vomiting, currant jelly stool and abdominal mass. There were 2 patients with history of preceding upper respiratory infection and 4 patients with leukocytosis. 4. Mean symptom duration was 37.4 hours. 5. By non-surgical managements, intussuscepta were reduced to the ileocecal area without reflux into the ileum. 6. Immediately after non-surgical managements, abdominal pain or irritability were subsided in all cases. Conclusion: If intussusceptum is reduced to the ileocecal area without reflux into the ileum by non-surgical management but abdominal pain or irritability were subsided immediately after that, surgical observation and repeated non-surgical management could be considered instead of immediate operation.

Individual differences in the reduction degree of the Korean suffix ‘nɨn’

Jungsun Kim 한국음성학회 2020 말소리와 음성과학 Vol.12 No.2

The present study examines the degree of suffix reduction that occurs when the Korean suffix [-nɨn] was attached to the root in spontaneous Seoul Korean speech. Specifically, it focuses on the degrees of reduction produced by individual speakers. The degree of reduction was assessed as the duration of the suffix [-nɨn] to clarify the continuum between the full and reduced forms. The results revealed that, first, the reduced forms of the suffix [-nɨn] were significantly distinguished from the full forms in the suffixation processes. Second, regarding parts of speech, the differences among individual speakers on the degrees of reduction were clearer when the suffix [-nɨn] was attached to verbs, rather than nouns and pronouns. Finally, the length of a root played a critical role in determining the degree of reduction of the suffix [-nɨn]. The degrees of reduction for individual speakers significantly differed when the suffix [-nɨn] was attached to two-syllable roots than three- and four-syllable roots. In conclusion, individual differences in the degrees of reduction were likely to occur when the roots are verbs and when two-syllable roots.

Rapid Spontaneous Reduction of a Huge Intracerebral Hematoma

Sung Hoon Han,이호국,문재곤,김창현,조탁근 대한뇌혈관외과학회 2012 Journal of Cerebrovascular and Endovascular Neuros Vol.14 No.2

Rapid reduction of a large acute subdural hematoma has been frequently reported. In my knowledge, however, it was rarely reported that rapid spontaneous reduction occurred in large volume of spontaneous intracerebral hematoma (sICH). We describe a patient with a rapid spontaneous decrease in the volume of a large hematoma. A 73-year-old man presented semi-comatose mentality. Initial brain computed tomography (CT) revealed the huge sICH. An emergency operation was planned, but was not performed due to the refusal of patient’s family. Therefore, we decided to treat with conservative therapy. However, follow-up brain CT 16 hours after initial scan showed a remarkable reduction of previous sICH. The mechanism involving the spontaneous rapid decrease of the hematoma is presumed to occur through redistribution in brain atrophy, compression effect from the increased intracranial pressure and dilution through a wash out by the cerebrospinal fluid.

기계화학적 활성에 의해 테이프에 자발적으로 환원된 은의 전기화학적 분석

윤창석 한국응용과학기술학회 2020 한국응용과학기술학회지 Vol.37 No.5

We electrochemically investigated driving force for spontaneous reduction of metal nanoparticle (NP) film on a scotch tape in electorlyte solution after mechanochemical activation. The amount of charge for spontaneous reduction of silver (Ag) on the tape was analyzed using anodic stripping voltammetry (ASV) and cyclic voltammetry (CV). The electrochemical results supported that the driving force for spontaneous reduction is mechanochemical radicals, not ions. 본 연구는 기계화학적 활성화 된 스카치테이프가 금속 이온 수용액에서 유발하는 자발적 금속 나노입자 필름 형성의 구동력과 그 크기를 전기화학적 방법으로 분석했다. 은 필름이 형성된 테이프를 질산에 녹이고, 완충용액과 섞어 전기화학 측정용 샘플을 준비했다. 양극 벗김 전압전류법의 피크 신호를 통해, 은 입자의 자발적 환원에 소모된 전하량을 측정했다. 이를 검정 곡선에 대입하여, 환원된 은의 양을 구했다. 그 결과 은의 양이 선행 연구 대비 10 6 배 많은 점, 수용액에서 전하를 가진 이온들의 짧은 수명을 참고하여, 자발적 반응의 구동력을 라디칼로 결론 냈다.

Spontaneous Rapid Reduction of a Large Acute Subdural Hematoma

이철희,강동호,황수현,박인성,정진명,한종우 대한의학회 2009 Journal of Korean medical science Vol.24 No.6

The majority of acute post-traumatic subdural hematomas (ASDH) require urgent surgical evacuation. Spontaneous resolution of ASDH has been reported in some cases. We report here on a case of a patient with a large amount of ASDH that was rapidly reduced. A 61-yr-old man was found unconscious following a high speed motor vehicle accident. On initial examination, his Glasgow Coma Score scale was 4/15. His pupils were fully dilated and non-reactive to bright light. Brain computed tomography (CT) showed a massive right-sided ASDH. The decision was made to treat him conservatively because of his poor clinical condition. Another brain CT approximately 14 hr after the initial scan demonstrated a remarkable reduction of the previous ASDH and there was the new appearance of high density in the subdural space adjacent to the falx and the tentorium. Thirty days after his admission, brain CT revealed chronic SDH and the patient underwent surgery. The patient is currently able to obey simple commands. In conclusion, spontaneous rapid resolution/ reduction of ASDH may occur in some patients. The mechanisms are most likely the result of dilution by cerebrospinal fluid and the redistribution of hematoma especially in patients with brain atrophy.

Patterns of consonant deletion in the word-internal onset position

Kim, Jungsun,Yun, Weonhee,Kang, Ducksoo 한국음성학회 2016 말소리와 음성과학 Vol.8 No.1

This study examined the deletion of onset consonant in the word-internal structure in spontaneous Seoul Korean speech. It used the dataset of speakers in their 20s extracted from the Korean Corpus of Spontaneous Speech (Yun et al., 2015). The proportion of deletion of word-internal onset consonants was analyzed using the linear mixed-effects regression model. The factors that promoted the deletion of onsets were primarily the types of consonants and their phonetic contexts. The results showed that onset deletion was more likely to occur for a lenis velar stop [k] than the other consonants, and in the phonetic contexts, when the preceding vowel was a low central vowel [a]. Moreover, some speakers tended to more frequently delete onset consonants (e.g., [k] and [n]) than other speakers, which reflected individual differences. This study implies that word-internal onsets undergo a process of gradient reduction within individuals’ articulatory strategies.

Patterns of consonant deletion in the word-internal onset position: Evidence from spontaneous Seoul Korean speech

김정선,윤원희,강덕수 한국음성학회 2016 말소리와 음성과학 Vol.8 No.1

This study examined the deletion of onset consonant in the word-internal structure in spontaneous Seoul Korean speech. It used the dataset of speakers in their 20s extracted from the Korean Corpus of Spontaneous Speech (Yun et al., 2015). The proportion of deletion of word-internal onset consonants was analyzed using the linear mixed-effects regression model. The factors that promoted the deletion of onsets were primarily the types of consonants and their phonetic contexts. The results showed that onset deletion was more likely to occur for a lenis velar stop [k] than the other consonants, and in the phonetic contexts, when the preceding vowel was a low central vowel [a]. Moreover, some speakers tended to more frequently delete onset consonants (e.g., [k] and [n]) than other speakers, which reflected individual differences. This study implies that word-internal onsets undergo a process of gradient reduction within individuals’ articulatory strategies.